Similar to Suatu keadaan/kondisi/peralatan/ metode/ material yang dapat mengakibatkan (berpotensi) menimbulkan kerugian bagi keselamatan maupun kesehatan pekerja
Similar to Suatu keadaan/kondisi/peralatan/ metode/ material yang dapat mengakibatkan (berpotensi) menimbulkan kerugian bagi keselamatan maupun kesehatan pekerja (20)
Suatu keadaan/kondisi/peralatan/ metode/ material yang dapat mengakibatkan (berpotensi) menimbulkan kerugian bagi keselamatan maupun kesehatan pekerja
1. SASARAN
PEMBELAJARAN
• Umum
• Mampu melakukan manajemen risiko kesehatan kerja
• Khusus
• Mampu menjelaskan tentang konsep bahaya, risiko dan
manajemen risiko kesehatan kerja
• Mampu menjelaskan proses dan langkah-langkah
manajemen risiko kesehatan kerja
• Mampu menyusun program pengendalian risiko
kesehatan kerja
1
2. KONSEP BAHAYA, RISIKO &
MANAJEMEN RISIKO
Teori bahaya dan risiko K3
Bahaya dan risiko Kesehatan Kerja
Konsep manajemen risiko
2
4. APA ITU HAZARD?
Hazard - noun [C] : something that is dangerous and likely to cause damage
Hazard - verb [T] : to risk doing something, especially making a guess, suggestion, etc.
4
Hazard
Cambridge Dictionaries Online
5. DEFINISI HAZARD
a anything (including work practices or procedures)
that has potential to harm the health or safety of a
person”
(Work cover, Australia)
a source or a situation with a potential for harm in
terms of human injury or ill-health, damage to
property, damage to the environment, or
combination of these
(AS 4801)
5
6. DEFINISI HAZARD
• hazard represents a source of energy with the potential
of causing immediate injury to personnel and damage to
equipment, environment or structure
(Zimolong and Trimpop, ILO encyclopaedia )
• as a source of potentially damaging energy is the basis
for several models of accident causation
(refer Viner, 1991)
Manajemen Risiko Kesehatan Kerja - Hendra (0813 6072 2587) 6
"Wear your goggles, Fool!"
7. DEFINISI HAZARD
Suatu keadaan/kondisi/peralatan/ metode/ material yang
dapat mengakibatkan (berpotensi) menimbulkan
kerugian bagi keselamatan maupun kesehatan pekerja
Definisi dari hazard (bahaya) mengindikasikan adanya
suatu ancaman, dan hazard bisa hadir tanpa risiko
7
8. TYPES OF HAZARD
• physical - radiation, magnetic fields, pressure extremes (high
pressure or vacuum), noise, vibration, etc,
• chemical - depends on the physical, chemical and toxic properties
of the chemical.
• biological - bacteria, viruses, insects, plants, birds, animals, and
humans, etc.,
• ergonomic - repetitive movements, improper set up of workstation,
etc.,
• safety - slipping/tripping hazards, inappropriate machine guarding,
equipment malfunctions or breakdowns
• psychosocial - stress, violence, etc.,
Sumber: (CCOHS)
Manajemen Risiko Kesehatan Kerja - Hendra (0813 6072 2587) 8
9. SUMBER
HAZARDS
Hazard di tempat kerja dapat berasal dari
setiap komponen proses kerja
9
Manusia
Lingkungan kerja
Metode/cara kerja
Material dan
Bahan
Mesin dan
Peralatan
Tenaga kerja
Manajemen
Perilaku
Kebijakan
Alat kerja
Mesin
Stasiun kerja
Lingkungan (alam)
Masyarakat, sosial &
peraturan
Prosedur
Praktek kerja (aktual)
Digunakan
Dihasilkan/dibuat
20. BAHAYA
ERGONOMI
(CONTOH)
No.
Bahaya
Ergonomi
Lokasi Pekerja Yang Paling Berisiko
1 Pekerjaan yang
dilakukan
secara manual
Area pasien dan tempat
penyimpanan barang
(gudang)
Petugas yang menangani pasien
(mengangkat dan memindahkan
pasien) dan barang
2 Postur yang
salah dalam
melakukan
pekerjaan
Kantor/administrasi Postur tubuh yang salah saat
duduk lama di kantor
Poli Gigi Dokter gigi saat melakukan
pemeriksaan rongga mulut
3 Pekerjaan yang
berulang
Semua area Dokter gigi, petugas pembersih,
fisioterapis, sopir, operator
komputer, yang berhubungan
dengan pekerjaan juru tulis
20
22. No. Bahaya Biologi Lokasi
Pekerja Yang Paling
Berisiko
1 AIDS, Hepatitis B
dan Non ANon B
IGD, kamar Operasi,
ruang pemeriksaan gigi,
laboratorium, laundry
Dokter, dokter gigi,
perawat, petugas
laboratorium, petugas
sanitasi dan laundry
2 Cytomegalovirus Ruang kebidanan,
ruang anak
Perawat, dokter yang
bekerja di bagian Ibu
dan anak
3 Rubella Ruang ibu dan anak Dokter dan perawat
4 Tuberculosis Bangsal, laboratorium,
ruang isolasi
Perawat, petugas
laboratorium,
fisioterapis
BAHAYA BIOLOGI
(CONTOH)
22
25. POTENSI
BAHAYA
MENURUT AREA
KERJA:
PENUNJANG
PELAYANAN
PASIEN
25
AREA PAJANAN
Farmasi Absorbsi obat-obatan, ergonomi, kecelakaan,
Lateks
Sentral Sterilisasi Gas anestesi, Compressed gases, Bahan
sterilisasi, pembersih, Ergonomi, kecelkn
Laundry Bahan cucian terkontaminasi, Bising, Panas,
Kecelakaan, kebakaran, mengangkat beban
Urusan Rumah
Tangga
Cairan pembersih, bahan terkontaminasi, lateks,
beban mengangkat
Dapur Panas, kebakaran/listrik,
Pembuangan
Limbah
Bahan terkontaminasi, radiasi, benda tajam
26. APA ITU EKSPOSURE
26
• Pajanan
• Paparan
KONTAK
• Eksposur adalah terjadinya kontak antara bahaya
dengan pekerja, atau
• Eksposur adalah hazard yang kontak pada
pekerja
27. DEFINISI
EKSPOSURE
The key word in the definition of exposure is
contact
Exposure does not result only from the presence of
a harmful agent in the environment, but must be
contact between the agent and the outer boundary
of the human body, such as the airways, the skin
and the mouth
Exposure may be defined as “the contact of a
chemical, physical, or biological agent with the outer
boundary of an organism”.
Exposure is often defined as a function of
concentration and time
27
29. 4 IMPORTANT ASPECTS TO DETERMINATION
OF EXPOSURE
1. The nature of the agent (chemical, physical, and biological
properties)
2. The intensity of exposure (how much [concentration] of the
agent)
3. The duration of exposure (for how long a time)
4. The frequency of exposure (How often)
Exposure is quantified as the concentration of an agent in
contact with the human body, averaged or integrated over time
(duration) of contact.
29
30. DEFINISI RISIKO
Risk is the potential for realization
of unwanted, negative
consequences from an event
in the financial arena, risk can be a
measure of the level of uncertainty
30
31. DEFINISI RISIKO
• Seberapa besar kemungkinan suatu
bahan/material, proses, atau kondisi
untuk menimbulkan kerusakan atau
kesakitan (kerugian).
31
32. RISK FORMULATION
• Risk = harm/injury x probability of injury
• Harm/injury = Hazard x Exposure
• Exposure = Concentration x Duration
• Risk = Hazard x Concentration x Duration x Probability of Injury
• Risk = Consequence x Likelihood
• R = C X L
3
2
33. RISK FORMULATION
• SAFETY RISK
• Risk = Consequence x Likelihood
• R = C X L
3
3
• HEALTH RISK
• Risk = Hazard x Exposure
• R = H x E
34. PERBEDAAN
HEALTH AND
SAFETY RISK
34
Risiko keselamatan
Risiko kesehatan
Jenis Risiko Probabilitas
Konsekuensi
(Dampak)
Kesehatan Tinggi atau sering Rendah atau ringan
Keselamatan Rendah atau jarang Tinggi atau Parah
35. HAZARD – EKSPOSUR - RISIKO
35
Manusia
Lingkungan
kerja
Mesin dan
Peralatan
Material dan
Bahan
Metode/prosedu
r/cara kerja
Komponen proses kerja
Hazards
Risiko
E
k
s
p
o
s
u
r
36. DEFINISI MANAJEMEN
RISIKO
Manajemen
Upaya yang dilakukan untuk meminimalkan
atau menerima outcome yang tidak diinginkan.
Risiko
Probabilitas suatu outcome yang tidak
diinginkan yang dapat berkisar dari rendah/minor
sampai tinggi/severe.
36
This Photo by Unknown Author is licensed under CC BY-SA
37. DEFINISI MANAJEMEN
RISIKO
Manajemen risiko adalah suatu proses pengelolaan
risiko dengan melakukan identifikasi, evaluasi, dan
pengendalian serta melakukan monitoring secara
berkelanjutan sehingga terwujud tempat kerja atau
proses kerja dengan risiko yang dapat diterima
(acceptable) dari sudut pandang proses, keselamatan
dan kesehatan.
37
38. TUJUAN MANAJEMEN
RISIKO
1) To maximise progress towards the organisational objectives while minimising losses.
2) To improve decision making at all levels
3) To use risk as a planning tool
4) To reduce “Blame” and improve team spirit
5) To avoid missed deadlines and improve predictability.
6) To reduce costs resulting from damaging events and prevent budget overruns.
7) To satisfy stakeholders by avoiding damaging events of direct interest to them.
8) To identify areas where contingency plans are needed.
9) To resolve problems early. Early detection makes risks less expensive to handle.
10) To highlight documented risks. This makes them hard to ignore.
11) To prepare contingency plans where necessary.
12) To resolve problems early because early detection or risks is less costly.
13) To cause expectations to be more realistic.
Manajemen Risiko Kesehatan Kerja - Hendra (0813 6072 2587) 38
41. PROSES MANAJEMEN RISIKO
Monitoring dan
Evaluasi
Penanganan
Risiko
Evaluasi Risiko
Analisis Risiko
Identifikasi
Risiko
Penetapan
Konteks
Komunikasi
dan Konsultasi
41
42. PROSES MANAJEMEN RISIKO
• Komikanikasi dan konsultasi adalah hal penting
• Untuk mengembangkan rencana komunikasi untuk kedua pemangku kepentingan internal dan
eksternal
• Untuk memastikan bahwa mereka yang bertanggung jawab untuk menerapkan manajemen
risiko, dan mereka yang memiliki kepentingan tertentu memahami dasar keputusan yang dibuat
dan mengapa tindakan tertentu diperlukan
42
Komunikasi
dan Konsultasi
43. PROSES MANAJEMEN RISIKO
• Penetapan konteks strategis
• Hubungan antara organisasi dan lingkungannya
• Kekuatan, kelemahan, peluang, dan ancaman organisasi
• Keuangan, operasional (termasuk K3L), kompetitif, politik
• Pemangku kepentingan (stake holder) internal dan eksternal
• Penetapan konteks organisasi
• Penetapan konteks manajemen risisko
• Aktivitas pemeriksaan pasien
• Pertolongan persalinan
• Penanganan limbah medis
• dll
• Penetapan kriteria risiko
• Menentukan struktur
43
Penetapan
Konteks
44. PROSES MANAJEMEN RISIKO
• Identifikasi risiko difokuskan pada ruang lingkup yang telah di tetapkan.
• Identifikasi risiko biasanya diawali dengan identifikasi bahaya
• Identifikasi dilakukan dengan menjawab pertanyaan:
1. Apa yang dapat terjadi ?
2. Kapan/bilamana hal tersebut dapat terjadi ?
3. Mengapa hal tersebut dapat terjadi ?
4. Bagaimana (proses) hal tersebut dapat terjadi ?
5. Berapa besaran bahaya yang terjadi ?
44
Identifikasi
Risiko
45. PROSES MANAJEMEN RISIKO
• Penilaian risiko bertujuan untuk menentukan tingkat risiko kesehatan dari setiap bahaya kesehatan
yang teridentifikasi.
• Dalam penilaian risiko, maka diperlukan informasi tentang:
• Analisis risiko dapat dilakukan secara kualitatif, kuantitatif, dan semi kuantitatif
• Perbedaan setiap metode terdapat pada penentuan Konsekuensi dan Likelihood
45
Analisis Risiko
Pengendalian yang
sudah dilakukan, terkait
dengan risiko yang
teridentifikasi
Menentukan probabilitas
pajanan bahaya
Menentukan tingkat
konsekuensi (dampak)
Penetapan tingkat risiko
kesehatan
47. QUALITATIVE HEALTH EFFECT RATING
47
Category Description
0
1
2
3
4
Reversible effects of little concern or no known or
suspected adverse health effects.
Reversible health effects of concerns
Severe, reversible health effects of concern.
Irreversible health effects of concerns.
Life threatening or disabling injury or illness.
48. QUALITATIVE EXPOSURE RATING
48
Exposure can be by air, dermal, or ingestion routes.
Rating should not take into consideration the use of personal protective equipment.
CATEGORY DESCRIPTION
0 - No exposure No contact with agent
1 - Low exposure Infrequent contact with agent at low concentrations
2 – Moderate exposure Frequent contact with agent at low concentrations or infrequent contact
with agent at high concentrations
3 - High exposure Frequent contact with agent at high concentrations
4 - Very High exposure Frequent contact with agent at very high concentrations at very high
concentrations
50. QUALITATIVE MEASURES OF LIKELIHOOD
Level Descriptor Description
A Almost Certain The even is expected to occur in most circumstances
B Likely The event will probably occur in most circumstances
C Moderate The event should occur at some time
D Unlikely The event could occur
E Rare The event will only occur in unlikely circumstances
50
Australian Standard 4360 Risk Management
51. QUALITATIVE MEASURES OF CONSEQUENCES
Level Descriptor Description
1 Insignificant No injuries, low financial loss
2 Minor First aid required, on site release immediately contained,
medium financial loss
3 Moderate Medical treatment required, on site release contained with
outside assistance, high financial loss
4 Major Extensive injuries, loss of production capability, off site release
but no detrimental consequences, major financial loss
5 Catastrophic Death, toxic release off site, huge financial loss
51
Australian Standard 4360 Risk Management
52. RISK
CHART/MATRIX
52
High Risk , detailed research and management planning required at senior level
Significant risk, Senior management attention needed
Moderate Risk, management responsibility must be specified
Low Risk, manage by routine procedures
Australian Standard 4360 Risk Management
54. CONSEQUENCES CATEGORY
Category Description Ranking
Catastrophe Multiple fatalities damage over $ 1 million, closure of activity, permanent
extensive damage environmental
100
Disaster Fatality, permanent local damage to environment, loss $ 500,000 - $ 1,000,000 50
Very Serious Permanent disability/ill health, non permanent environmental damage $ 50,000
- $ 500,000 loss
25
Serious Serious but non permanent injury or ill health adverse effect on environment
$5,000 - $50,000 loss
15
Important Medical attention needed, off site emission but no damage. $500 - $5,000 loss 5
Noticeable Minor cuts and bruises or sickness, minor damage < $500 short loss of
production, small loss of containment no off site consequences
1
54
55. LIKELIHOOD CATEGORY
Category Description Ranking
Almost Certain The most likely outcome if the event occurs 10
Likely Not unusual perhaps 50-50 chance 6
Unusual but possible 3
Remotely Possible A possible coincidence 1
Conceivable Has never happened in years of exposure but is
possible
0,5
Practically impossible Not to knowledge ever happened anywhere 0,1
55
Likelihood = likelihood the particular consequence follows the event
56. SEMI QUANTITATIVE LEVEL OF RISK
• Risk = Consequences x Likelihood
• R = C x L
56
Risk Level Comment Action
> 350 Very High Stop activity until risk reduced
180 – 350 Priority 1 Deal with immediately
70 – 180 Substantial Correction required
20 – 70 Priority 3 Attention indicated
< 20 Acceptable Make as low as reasonable practical
57. EXAMPLE OF A BASIC SEMI-QUANTITATIVE RISK RATING
MATRIX
57
58. EXAMPLE OF AN ALTERNATIVE, BASIC SEMI-QUANTITATIVE
RISK RATING MATRIX
58
59. FORMULIR ANALISIS RISIKO KESEHATAN KERJA
59
Lokasi : Tanggal :
Unit : Pelaksana :
No Tugas Sumber
Jenis Bahaya Kesehatan
(Fisik, Kimia, Biologi,
Ergonomik, Psikososial)
Risiko
Probabilitas
(Exposure Rating)
Konsekuensi
(Efek Rating)
Pengendalian
yang ada
Tingkat
Risiko
62. PROSES ANALISIS KUANTITATIF
• Diawali dengan menetapkan kemungkinan outcome yang terjadi.
• Analisis konsekuensi dilakukan dengan melakukan analisis skenario terhadap suatu yang dapat terjadi jika dilakukan suatu
perubahan.
• Analisis skenario secara kualitatif dapat digunakan untuk melengkapi perhitungan, model, dan ekstrapolasi terhadap data
sebelumnya.
• Likelihood dihitung dengan melakukan estimasi kemungkinan suatu kejadian atau frekuensinya (seberapa sering kejadian
diharapkan terjadi)
• Total Risiko adalah Jumlah semua potensi risiko
64. EXAMPLE
• Suppose that it is proposed to spend $20,000 on new equipment that is expected to double production. The marketing department estimate
that there is a 40% chance that they can sell all the additional production making an extra profit of $20,000. However they tell you that there
is a 60% chance that the market will have to grow gradually and they can shell only half the extra capacity. This will give you a profit of
$10,000 and storage costs of $2500. ie a net profit of $7500. The risk for each possible outcome (sell all or sell half) is calculated then added
to give the risk of the decision. This is called the expected monetary value
64
Outcome Probability Consequences P x C Risk
Sell all 40 % + $20,000 40% x 20,000 $ 8,000
Sell 50% 60% $7,500 60% x 7,500 $ 4,500
Total 100% $ 12,500
Note : Total probability must be 1 or 100 %
65. PROSES MANAJEMEN RISIKO
• Perhitungan tingkat risiko:
• Risiko = Probability (Exposure) x Severity (Effect) Safety
• Risiko = Hazard x Consequence x Time (Frequency x Duration) Health
• Risiko, terdiri atas:
a) Risiko sebelum dikendalikan (Potensial risk/Existing Risk)
b) Risiko setelah dikendalikan (Residual Risk)
65
Analisis Risiko
66. PROSES MANAJEMEN RISIKO
• Melakukan evaluasi terhadap tingkat risiko yang diperoleh untuk setiap bahaya kesehatan kerja
• Evaluasi dilakukan dengan membandingkan hasil perhitungan tingkat risiko dengan kriteria yang
telah ditetapkan
• Menetapkan prioritas risiko, dengan menjawab kriteria:
1. Apakah risiko tersebut perlu dikendalikan atau dapat diterima ? (Low risk – acceptable)
2. High risk – treatment, bila perlu dikendalikan, bagaimana urgensinya ? (skala prioritas)
66
Evaluasi Risiko
67. PROSES MANAJEMEN RISIKO
• Pengendalian risiko bertujuan untuk menurunkan tingkat risiko sampai pada tingkat yang dapat
diterima.
• Tahapan pengendalian risiko meliputi:
67
Penanganan
Risiko
Penanganan
Risiko
Mengidentifikasi
alternatif metode
pengendalian
Mengevaluasi
alternatif metode
pengendalian
Memilih metode
pengendalian yang
tepat
Menyusun
perencanaan
implementasi
Pelaksanaan
program
pengendalian
68. PROSES MANAJEMEN RISIKO
• Untuk memantau efektivitas rencana perlakuan risiko, strategi dan sistem manajemen yang dibentuk untuk
memantau implementasi
• Untuk memastikan perubahan keadaan tidak mengubah prioritas risiko
• Untuk memastikan bahwa rencana manajemen tetap relevan
• Faktor dapat mempengaruhi kesesuaian atau biaya berbagai opsi pemeliharaan
68
Monitoring dan
Evaluasi
69. IDENTIFY TREATMENT OPTIONS
69
There are many treatment options.
• avoid the risk, by deciding not to start or continue with the activity
that gives rise to the risk
• reduce the risk,
• remove the source of the risk,
• modify the consequences,
• change the probabilities,
• share the risk with others, with another party or parties
(including contracts and risk financing)
• simply retain the risk, by informed decision
• increase the risk in order to pursue an opportunity.
70. IDENTIFY TREATMENT OPTIONS
70
The purpose of treatment plans is to document how the
chosen options will be implemented.
The treatment plans should include:
• proposed actions;
• resource requirements;
• responsibilities;
• timing;
• performance measures; and
• reporting and monitoring requirements.
Treatment plans should be integrated with the
management and budgetary processes of the
organization.
71. DOKUMEN MANAJEMEN RISIKO
• Semua aktivitas manajemen risiko harus terdokumentasi dan ter update
dengan baik dan rutin.
• Dokumen manajemen risiko dapat dalam bentuk:
• Pedoman manajemen risiko yang memuat antara lain, kebijakan, prosedur, hasil identifikasi,
analisis, evaluasi, dan tindakan pengendalian
• Dapat juga dalam bentuk dokumen HIRAC, HIRA, HIRADC, dll
Cikarang, 2 November 2018
Manajemen Risiko Kesehatan Kerja - Hendra (0813 6072 2587) 71
73. 4 PRINSIP PENGENDALIAN BAHAYA
Hazard Control Principles
• The first principle: all hazards can be controlled.
• The second principle: there are usually many alternate methods of control.
• The third principle: some methods of control are better than others.
• The fourth principle: some situations will require more than one control method to obtain
optimum results.
73
75. HIRARKI PENGENDALIAN BAHAYA
75
1. Eliminate the hazard altogether.
For example – get rid of the dangerous machine.
2. Substitute the hazard with a safer alternative.
For example – replace the machine with a safer one.
3. Isolate the hazard from anyone who could be harmed.
For example – keep the machine in a closed room and operate it remotely.
4. Use engineering controls to reduce the risk.
For example – attach guards to the machine to protect users.
5. Use administrative controls to reduce the risk.
For example – train workers how to use the machine safely.
6. Use personal protective equipment (PPE).
For example – wear gloves and goggles when using the machine.